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I began having symptoms in early February which at first alarmed me, but which I quickly dismissed as being something benign. I was having trouble seeing in a vague sort of way and I had two days of numbness in my extremities and face. Then a month later, while the vision had deteriorated into double vision and an extreme sensitivity to light, the numbness returned. Since that time, I have experienced heat intolerance, confusion, random muscle weakness and fatigue, more and more numbness and other paresthesia symptoms (burning, tingling, electric-shock type feelings, etc.), and dizziness.

All of my vision and paresthesia symptoms generally get worse in the evenings.

My PCP referred me to a neurologist (an MS specialist), but I wasn't having any symptoms other than the vision issues at the time of the appointment. The neuro did all of the usual tests and said his level of suspicion for MS was low, but he could see that I was clearly concerned so he ordered an MRI and an SSEP. My PCP ordered bloodwork and referred me to an opthalmologist.

The bloodwork apparently came back "within normal limits, and the ophthalmologist said my optic nerves looked healthy, my vision was fine, and that she couldn't see anything that would explain why I have double vision. She even did a visual field test and an OCT scan with no negative results.

I had an MRI and an SSEP and saw my neurologist today to review the results. He said he saw *nothing* on the MRI and the SSEP was normal. He believes I am suffering from stress and anxiety and asked if I would like to take an antidepressant. I didn't answer right away, so he suggested a psychologist and to follow up again with him (the neuro) in a month if symptoms persist.

Do any of you know someone for whom all these kinds of symptoms have really turned out to be "just" stress. As surprised as I was to hear that from the doctor, it would be a big relief, if it were true.

Thanks for your Reply!

9 Replies |Watch This Discussion | Report This| Share this:Could it really be only stress / anxiety?I began having symptoms in early February which at first alarmed me, but which I quickly dismissed as being something benign. I was having trouble seeing in a vague sort of way and I had two days of numbness in my extremities and face. Then a month later, while the vision had deteriorated into double vision and an extreme sensitivity to light, the numbness returned. Since that time, I have experienced heat intolerance, confusion, random muscle weakness and fatigue, more and more numbness and other paresthesia symptoms (burning, tingling, electric-shock type feelings, etc.), and dizziness.

All of my vision and paresthesia symptoms generally get worse in the evenings.

My PCP referred me to a neurologist (an MS specialist), but I wasn't having any symptoms other than the vision issues at the time of the appointment. The neuro did all of the usual tests and said his level of suspicion for MS was low, but he could see that I was clearly concerned so he ordered an MRI and an SSEP. My PCP ordered bloodwork and referred me to an opthalmologist.

The bloodwork apparently came back "within normal limits, and the ophthalmologist said my optic nerves looked healthy, my vision was fine, and that she couldn't see anything that would explain why I have double vision. She even did a visual field test and an OCT scan with no negative results.

I had an MRI and an SSEP and saw my neurologist today to review the results. He said he saw *nothing* on the MRI and the SSEP was normal. He believes I am suffering from stress and anxiety and asked if I would like to take an antidepressant. I didn't answer right away, so he suggested a psychologist and to follow up again with him (the neuro) in a month if symptoms persist.

Do any of you know someone for whom all these kinds of symptoms have really turned out to be "just" stress. As surprised as I was to hear that from the doctor, it would be a big relief, if it were true.

Are you actually under alot of stress? Stress can actually cause alot of problems but its quite irritating to me that simply because they can't find the cause the go to answer becauses "stress" so often. I know panic attacks can cause some nasty symptoms like heart palpitations and depression can definitely cause fatigue and confusion and you can be in such a state of stress that you hold yourself tense which can cause issues after a while. but usually you wouldn't see that full combo. But usually you wouldn't see that full combo together without knowing you are really stressed!

But I do understand that in the abcense of any physical indicators like reflex tests or medical test like MRIs all they can do suggest alternative answers and follow up in the future to see what has changed. I would definitely be keeping a journal of your health that you can share with your doctor.

I wish I could offer more helpful advice but I feel your pain as I know how frustrating it can be to be suffering with a big question mark over your head!

On one other note - did you verify that the neurologist was actually an MS specialist or just one who claims to be (I have seen it here locally, we have a couple who claim to be MS specialist but they have no specialized training in MS but that could just be a problem here)

Thanks for your Reply!

Report This| Share this:Could it really be only stress / anxiety?Are you actually under alot of stress? Stress can actually cause alot of problems but its quite irritating to me that simply because they can't find the cause the go to answer becauses "stress" so often. I know panic attacks can cause some nasty symptoms like heart palpitations and depression can definitely cause fatigue and confusion and you can be in such a state of stress that you hold yourself tense which can cause issues after a while. but usually you wouldn't see that full combo. But usually you wouldn't see that full combo together without knowing you are really stressed!

But I do understand that in the abcense of any physical indicators like reflex tests or medical test like MRIs all they can do suggest alternative answers and follow up in the future to see what has changed. I would definitely be keeping a journal of your health that you can share with your doctor.

I wish I could offer more helpful advice but I feel your pain as I know how frustrating it can be to be suffering with a big question mark over your head!

On one other note - did you verify that the neurologist was actually an MS specialist or just one who claims to be (I have seen it here locally, we have a couple who claim to be MS specialist but they have no specialized training in MS but that could just be a problem here)

I always cringe whenever someone has been given the stress/anxiety diagnosis. It's something a fair number of doctors tell a patient when they don't want to investigate further.

When I was having my first MS attack, I saw six doctors, two of whom suggested I was suffering from stress, anxiety, or panic attacks despite my having brisk reflexes, a limp, and muscle spasticity. I knew it wasn't any of those things and I kept seeing doctors until a neurologist tested me for MS. I did have two spine lesions, and he put me in the hospital for IV steroid therapy. But I didn't get an MS diagnosis for another six years. It is a diagnosis of exclusion, there is no one definitive test.

You asked whether it possible for your symptoms to be a result of stress or anxiety. Anxiety has been documented as manifesting itself in many different physical symptoms, and yes, numbness, muscle weakness, dizziness, and a host of other things can be from stress and anxiety. My sister suffers from anxiety to the point of getting pain and numbness in one arm and feeling like she's having a heart attack. She was hospitalized and tested, but her heart was normal.

But ask yourself these questions: Do you have a history of panic attacks, extreme stress, anxiety? Whenever you have been very stressed, have you ever had such symptoms?

My advice is to keep track of your symptoms. If these things happen again, go to your PCP. It might not be MS, other conditions can cause these symptoms, too, including vitamin deficiencies. The main thing is to keep investigating until you get some answers and the proper treatment.

I always cringe whenever someone has been given the stress/anxiety diagnosis. It's something a fair number of doctors tell a patient when they don't want to investigate further.

When I was having my first MS attack, I saw six doctors, two of whom suggested I was suffering from stress, anxiety, or panic attacks despite my having brisk reflexes, a limp, and muscle spasticity. I knew it wasn't any of those things and I kept seeing doctors until a neurologist tested me for MS. I did have two spine lesions, and he put me in the hospital for IV steroid therapy. But I didn't get an MS diagnosis for another six years. It is a diagnosis of exclusion, there is no one definitive test.

You asked whether it possible for your symptoms to be a result of stress or anxiety. Anxiety has been documented as manifesting itself in many different physical symptoms, and yes, numbness, muscle weakness, dizziness, and a host of other things can be from stress and anxiety. My sister suffers from anxiety to the point of getting pain and numbness in one arm and feeling like she's having a heart attack. She was hospitalized and tested, but her heart was normal.

But ask yourself these questions: Do you have a history of panic attacks, extreme stress, anxiety? Whenever you have been very stressed, have you ever had such symptoms?

My advice is to keep track of your symptoms. If these things happen again, go to your PCP. It might not be MS, other conditions can cause these symptoms, too, including vitamin deficiencies. The main thing is to keep investigating until you get some answers and the proper treatment.

I've been going through almost the exact same thing. I have been under stress due to illness in my family and the death of my mother (caring for her at the end of her journey last summer) but I thought I was handeling it pretty well. I've always had migraines but they are more often now and for longer periods of time. This has been going on for about a year. In addition for the past 10 years I've had extreme feet/leg cramps at night. To the point I wake up screaming. Then in March things started to get worse, I was dizzy to the point I would stumble and fall and had to crawl up and down my stairs. Then my face started to get numb around my lips and I would slur my words a little.My vision also went wacky, I can hardly read now. I'm tired and just plain hurt. I went to my PCP who said "I'd bet money you have MS" and ordered an MRI. The MRI came back negative for MS but a small tumor that may have been there for years and the doctor who read the MRI is pretty sure its benign and to have a follow up MRI in 3 months. My PCP said he was still suprised the MRI didnt show MS so all my problems must be due to stress. He did give me meds for the dizzyness and anxiety (that makes me really off kilter so I don't take them). He did blood work and it came back good except I'm anemic. That's it, no further appointments...nothing scheduled. The numbness has gotten better, not totally gone, some days I'm more dizzy then others. Muscle cramps, vision and headaches remain the same. I don't know where to turn next. Advise???

Thanks for your Reply!

Report This| Share this:Could it really be only stress / anxiety?I've been going through almost the exact same thing. I have been under stress due to illness in my family and the death of my mother (caring for her at the end of her journey last summer) but I thought I was handeling it pretty well. I've always had migraines but they are more often now and for longer periods of time. This has been going on for about a year. In addition for the past 10 years I've had extreme feet/leg cramps at night. To the point I wake up screaming. Then in March things started to get worse, I was dizzy to the point I would stumble and fall and had to crawl up and down my stairs. Then my face started to get numb around my lips and I would slur my words a little.My vision also went wacky, I can hardly read now. I'm tired and just plain hurt. I went to my PCP who said "I'd bet money you have MS" and ordered an MRI. The MRI came back negative for MS but a small tumor that may have been there for years and the doctor who read the MRI is pretty sure its benign and to have a follow up MRI in 3 months. My PCP said he was still suprised the MRI didnt show MS so all my problems must be due to stress. He did give me meds for the dizzyness and anxiety (that makes me really off kilter so I don't take them). He did blood work and it came back good except I'm anemic. That's it, no further appointments...nothing scheduled. The numbness has gotten better, not totally gone, some days I'm more dizzy then others. Muscle cramps, vision and headaches remain the same. I don't know where to turn next. Advise???

Hi. Since January I have had numbness on the left side three times which they have said at first (in Janurary) was a minor stroke. It is only a sensory thing. Just numbness. Not motor related much. I still can move around some. The first time they did a CT scan and the Nuerologist said she did not see any stroke on the scans and sent me home the next day. The numbness starts in my face and radiates slowly down my left side. It happened again and I didn't tell anyone. Then it happened again on 4-18-2014 and I did not call my PCP until Monday at which time he told me to go to ER. I was in the hospital 4 days. They did two MRI's one with and one without contrast. CT scans and a Lumbar Puncture. This time the Neurologist said that something was definitely going on and that the first MRI in January showed white spots on my brain and that they had increased on the latest MRI's. She said she believed it was MS. I do not have double vision but I have noticed a distinct vision change in the right eye. I have Physical Therapists working with me and they all agree that these TIA's (mini-strokes). I had one doctor tell me I was hyperventilating!!! I laughed in his face to which he replied that it was probably migraine symptoms without the headache. I am not seeing that doctor anymore. Nuts!!! I still don't know the results on the Lumbar Puncture to see if the MS Marker is there. I am so frustrated, I could scream. Does anybody know what they are doing anymore or just how stressful this is? Yes, I believe that stress can kill you. It may just cause me to have a major stroke, if I don't get some answers. Ugh!

Thanks for your Reply!

Report This| Share this:Could it really be only stress / anxiety?Hi. Since January I have had numbness on the left side three times which they have said at first (in Janurary) was a minor stroke. It is only a sensory thing. Just numbness. Not motor related much. I still can move around some. The first time they did a CT scan and the Nuerologist said she did not see any stroke on the scans and sent me home the next day. The numbness starts in my face and radiates slowly down my left side. It happened again and I didn't tell anyone. Then it happened again on 4-18-2014 and I did not call my PCP until Monday at which time he told me to go to ER. I was in the hospital 4 days. They did two MRI's one with and one without contrast. CT scans and a Lumbar Puncture. This time the Neurologist said that something was definitely going on and that the first MRI in January showed white spots on my brain and that they had increased on the latest MRI's. She said she believed it was MS. I do not have double vision but I have noticed a distinct vision change in the right eye. I have Physical Therapists working with me and they all agree that these TIA's (mini-strokes). I had one doctor tell me I was hyperventilating!!! I laughed in his face to which he replied that it was probably migraine symptoms without the headache. I am not seeing that doctor anymore. Nuts!!! I still don't know the results on the Lumbar Puncture to see if the MS Marker is there. I am so frustrated, I could scream. Does anybody know what they are doing anymore or just how stressful this is? Yes, I believe that stress can kill you. It may just cause me to have a major stroke, if I don't get some answers. Ugh!

Don't be too quick to think that hyperventilation is not happening. I had symptoms for two years. Eyesight problems, seizures, ants crawling all over my arms, legs and feet, terrible pain and cramping in my legs. This was in 1972 and I was only 12 years old. In 1973 Mayo clinic called it MS. (WAY before such things as MRI's). In fact they would force me to hyperventilate and then a seizure would start again!

Many, many years later (1986) double vision again - an optometrist told me I had optic Neuritis and an MRI confirmed MS. In 2010 I started having seizures again. They were occurring 1-2 times per week, When it happened I couldn't walk, stand, or speak, but I was aware of everything going on around me. In the ER they had no idea what to do. They ruled out stroke right away, but once they gave me valium I calmed down the shaking and pain subsided and I went home. After many different doctors I finally went to a Neurologist specializing in seizures. She confirmed that the seizures were panic attacks brought on by stress. For 3 years I kept the 1mg valium prescription with me and when I felt a seizure coming on I would take one. It always worked. In late 2013 I felt a seizure coming on and didn't have the meds with me. I relaxed and breathed my way through it. The burning, shaking and pain came, but I didn't loose my speaking ability and within 10 min. it subsided. I still keep the valium with me, but now I know it is just a panic attack and I have been able to force myself to relax, breathe and calm down so it doesn't go any further.

MS is difficult to diagnose, even today and it can take years of symptoms before lesions show up in an MRI. My point is even if you do have MS, don't rule out the affect stress or panic attacks can have on your brain. Yes I did have RRMS and now it has moved into secondary progressive, but I am also 55 years old now. I can still walk, slowly and with a cane, but I am still moving every day. My children are 29 and 30, married and both very successful today.

Stay active and keep looking for the next big thing, but ENJOY YOUR LIFE! It is too short to get caught up in the 'what ifs'. There is relief out there. I use this website to get the latest information on anything medical: http://www.medicalnewstoday.com/

If you want to consider a clinical trial (which I have done and it gave me 10 years without a single symptom) go to www.clinicaltrials.gov It has every clinical trial going on for anything not just MS. Be well. Marge

Thanks for your Reply!

Report This| Share this:Could it really be only stress / anxiety?Don't be too quick to think that hyperventilation is not happening. I had symptoms for two years. Eyesight problems, seizures, ants crawling all over my arms, legs and feet, terrible pain and cramping in my legs. This was in 1972 and I was only 12 years old. In 1973 Mayo clinic called it MS. (WAY before such things as MRI's). In fact they would force me to hyperventilate and then a seizure would start again!

Many, many years later (1986) double vision again - an optometrist told me I had optic Neuritis and an MRI confirmed MS. In 2010 I started having seizures again. They were occurring 1-2 times per week, When it happened I couldn't walk, stand, or speak, but I was aware of everything going on around me. In the ER they had no idea what to do. They ruled out stroke right away, but once they gave me valium I calmed down the shaking and pain subsided and I went home. After many different doctors I finally went to a Neurologist specializing in seizures. She confirmed that the seizures were panic attacks brought on by stress. For 3 years I kept the 1mg valium prescription with me and when I felt a seizure coming on I would take one. It always worked. In late 2013 I felt a seizure coming on and didn't have the meds with me. I relaxed and breathed my way through it. The burning, shaking and pain came, but I didn't loose my speaking ability and within 10 min. it subsided. I still keep the valium with me, but now I know it is just a panic attack and I have been able to force myself to relax, breathe and calm down so it doesn't go any further.

MS is difficult to diagnose, even today and it can take years of symptoms before lesions show up in an MRI. My point is even if you do have MS, don't rule out the affect stress or panic attacks can have on your brain. Yes I did have RRMS and now it has moved into secondary progressive, but I am also 55 years old now. I can still walk, slowly and with a cane, but I am still moving every day. My children are 29 and 30, married and both very successful today.

Stay active and keep looking for the next big thing, but ENJOY YOUR LIFE! It is too short to get caught up in the 'what ifs'. There is relief out there. I use this website to get the latest information on anything medical: http://www.medicalnewstoday.com/

If you want to consider a clinical trial (which I have done and it gave me 10 years without a single symptom) go to www.clinicaltrials.gov It has every clinical trial going on for anything not just MS. Be well. Marge

I also have been dealing with unusual symptoms and can relate to what many of you have already posted. Mine began last summer with serious pain in back and legs. Within days I was dealing with tingling sensations (doctors are now calling neuropathy) first in my feet and legs and then in my fingers, hands and lower arms. Then anxiety introduced itself to me for the first time in my 42 years! I thought I was having a heart attack and had dear friends from church take me to ER in the middle of the night when it woke me up. Turns out it was a full out panic attack. Something I have never before experienced in my life. This was first time that MS was even mentioned to me, as they took bloodwork and CT scans and x-rays. Everything showed I was completely healthy. From there, I was led from one doctor to another...specialist after specialist, ruling out things like Limes Disease, Rheumatoid Arthritis, and Lupus. Anxiety got so bad my doctor tried anxiety meds, but these only made my anxiety worse! I couldn't even function! So after much insistence on my part, she finally allowed me to wean off of them. When I was finally referred to a Nuerologist, she immediately suspected MS just in my story and in the basic tests she did on that first visit to her. I had no idea that my balance was so horrible until she had me try to walk a straight line, heal to toe, heal to toe. I seriously looked like I had been drinking. What was even more alarming to me was when she tested areas of my numbness and tingling...she used an instrument on me to see if I could tell temperature (hot or cold) when touching certain parts of my feet, legs, hands, and arms. I was shocked that the areas where I had the tingling felt like the instrument was hot, but as she moved up my legs and arms...the instrument felt cold (as it should be). It was a serious eye-opener for me and my husband who was with me at this first appointment. She then called for a full-body MRI, which we did in January of this year. The results on that showed "non-definitive abnormalities on the brain", but the spine looked clean. Again, she believed this was another sign that I have MS. But, the MRI also picked up some nodules on my thyroid that she wanted me to get checked out first before proceeding with anymore MS testing....specifically a lumbar tap.

SO, after a few weeks of undergoing an ultrasound and then a needle biopsy, it was found that I had a couple of areas on my right side of the thyroid that could be cancer. My endocrinologist immediately referred me for surgery, which was done in late February. My surgeon had warned me that she may have to remove my whole thyroid if they find reason to warrant it during surgery. Praise God, they only had to remove the right side and while I was in the hospital I was told it didn't appear to be cancer. However, when the frozen specimen biopsy report came back to the surgeon from the lab a week later, they did find a very small and isolated spot of carcinoma. All the doctors felt that we caught it early enough that it didn't have time to spread. They also believed that this could very well have caused all my symptoms.

OK, so now here I am in May and have just been put on thyroid replacements because my levels are too low. But I am also not seeing any change in my tingling sensations, often have this crawling feeling up the back of my head, my body is always feeling fatigued as if I worked out too hard or something (and I have barely walked around my house), and then the most recent is the troubling vision issue. I woke up one night about a week ago and could not see anything out of my left eye. It freaked me out...but it only lasted for about 5 minutes. But then I started to also notice that my vision seemed to have like a fog I was looking through...like a gray haze that I was trying to focus through so I could read a book. My night vision has always been bad, but I have noticed it has gotten increasingly worse over the past several months. MS?

Thanks for your Reply!

Report This| Share this:Could it really be only stress / anxiety?I also have been dealing with unusual symptoms and can relate to what many of you have already posted. Mine began last summer with serious pain in back and legs. Within days I was dealing with tingling sensations (doctors are now calling neuropathy) first in my feet and legs and then in my fingers, hands and lower arms. Then anxiety introduced itself to me for the first time in my 42 years! I thought I was having a heart attack and had dear friends from church take me to ER in the middle of the night when it woke me up. Turns out it was a full out panic attack. Something I have never before experienced in my life. This was first time that MS was even mentioned to me, as they took bloodwork and CT scans and x-rays. Everything showed I was completely healthy. From there, I was led from one doctor to another...specialist after specialist, ruling out things like Limes Disease, Rheumatoid Arthritis, and Lupus. Anxiety got so bad my doctor tried anxiety meds, but these only made my anxiety worse! I couldn't even function! So after much insistence on my part, she finally allowed me to wean off of them. When I was finally referred to a Nuerologist, she immediately suspected MS just in my story and in the basic tests she did on that first visit to her. I had no idea that my balance was so horrible until she had me try to walk a straight line, heal to toe, heal to toe. I seriously looked like I had been drinking. What was even more alarming to me was when she tested areas of my numbness and tingling...she used an instrument on me to see if I could tell temperature (hot or cold) when touching certain parts of my feet, legs, hands, and arms. I was shocked that the areas where I had the tingling felt like the instrument was hot, but as she moved up my legs and arms...the instrument felt cold (as it should be). It was a serious eye-opener for me and my husband who was with me at this first appointment. She then called for a full-body MRI, which we did in January of this year. The results on that showed "non-definitive abnormalities on the brain", but the spine looked clean. Again, she believed this was another sign that I have MS. But, the MRI also picked up some nodules on my thyroid that she wanted me to get checked out first before proceeding with anymore MS testing....specifically a lumbar tap.

SO, after a few weeks of undergoing an ultrasound and then a needle biopsy, it was found that I had a couple of areas on my right side of the thyroid that could be cancer. My endocrinologist immediately referred me for surgery, which was done in late February. My surgeon had warned me that she may have to remove my whole thyroid if they find reason to warrant it during surgery. Praise God, they only had to remove the right side and while I was in the hospital I was told it didn't appear to be cancer. However, when the frozen specimen biopsy report came back to the surgeon from the lab a week later, they did find a very small and isolated spot of carcinoma. All the doctors felt that we caught it early enough that it didn't have time to spread. They also believed that this could very well have caused all my symptoms.

OK, so now here I am in May and have just been put on thyroid replacements because my levels are too low. But I am also not seeing any change in my tingling sensations, often have this crawling feeling up the back of my head, my body is always feeling fatigued as if I worked out too hard or something (and I have barely walked around my house), and then the most recent is the troubling vision issue. I woke up one night about a week ago and could not see anything out of my left eye. It freaked me out...but it only lasted for about 5 minutes. But then I started to also notice that my vision seemed to have like a fog I was looking through...like a gray haze that I was trying to focus through so I could read a book. My night vision has always been bad, but I have noticed it has gotten increasingly worse over the past several months. MS?

An_256328 responded:

If you live in area where there are ticks, you might consider whether or not you might have Lyme Disease. This tick borne disease can cause vision problems as well as neurological problems. However since it is not well known you might find your PCP reacting with skepticism. There are tests for L.D. but they are not very accurate, missing many cases. But perhaps you will be lucky.

Thanks for your Reply!

Report This| Share this:Could it really be only stress / anxiety?If you live in area where there are ticks, you might consider whether or not you might have Lyme Disease. This tick borne disease can cause vision problems as well as neurological problems. However since it is not well known you might find your PCP reacting with skepticism. There are tests for L.D. but they are not very accurate, missing many cases. But perhaps you will be lucky.

Thanks to all of you. I am seeing the Neurologist on Wednesday. Hopefully to get some answers. My PCP wants to see me on Thursday or Friday. I now how new sypmptoms of a pounding heart beat (I have a history of Left Bundle Branch Block) and blood pressure issues. I have in the past had these little feeling that my whole body was twitching. Could these have been seisures? Don't know. I know that stress is driving up my B/P. Makes me crazy not getting any definitive answers. I know the MS is difficult to diagnose but I wonder now if that may be what has been going on for year and just not diagnoses. I hope to get some answers Wednesday. Thanks for you replies.

Thanks for your Reply!

Report This| Share this:Could it really be only stress / anxiety?Thanks to all of you. I am seeing the Neurologist on Wednesday. Hopefully to get some answers. My PCP wants to see me on Thursday or Friday. I now how new sypmptoms of a pounding heart beat (I have a history of Left Bundle Branch Block) and blood pressure issues. I have in the past had these little feeling that my whole body was twitching. Could these have been seisures? Don't know. I know that stress is driving up my B/P. Makes me crazy not getting any definitive answers. I know the MS is difficult to diagnose but I wonder now if that may be what has been going on for year and just not diagnoses. I hope to get some answers Wednesday. Thanks for you replies.

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